NSG 6420 EXAM 1 COMPLETE QUESTIONS WITH ANSWERS 100%
VERIFIED 2025 LATEST UPDATED ALREADY GRADED A+
Question 1
A 72-year-old male patient presents for an annual wellness exam. He complains that he
needs brighter light to read and has difficulty distinguishing between blue and green colors.
Based on normal age-related changes, what is the most likely physiological cause of these
symptoms?
A) Development of acute angle-closure glaucoma.
B) Yellowing and thickening of the lens (Nuclear Sclerosis).
C) Detachment of the retina.
D) Degeneration of the macula lutea.
E) Atrophy of the lacrimal ducts.
Correct Answer: B) Yellowing and thickening of the lens (Nuclear Sclerosis)
Rationale: As part of normal aging, the lens of the eye accumulates insoluble proteins,
causing it to thicken, harden, and turn yellow. This yellowing filters out shorter
wavelengths of light (blues and violets), altering color perception (specifically blue-green
discrimination). The thickening also requires more ambient light for light to penetrate to
the retina.
Question 2
During a cardiovascular assessment of an 80-year-old female, the Nurse Practitioner notes
a systolic blood pressure of 150 mmHg and a diastolic pressure of 80 mmHg (Isolated
Systolic Hypertension). Which age-related physiological change best explains this finding?
A) Increased elasticity of the aorta.
B) Increased sensitivity of the baroreceptors.
C) Stiffening of the large arteries (arteriosclerosis) and loss of elastic recoil.
D) Severe stenosis of the renal arteries.
E) Increased cardiac output at rest.
Correct Answer: C) Stiffening of the large arteries (arteriosclerosis) and loss of elastic
recoil.
Rationale: A hallmark of cardiovascular aging is the stiffening of the large elastic arteries
(aorta and major branches) due to collagen deposition and calcium accumulation. This loss
of elasticity (compliance) causes the systolic pressure to rise as the vessel cannot expand to
accommodate the stroke volume, resulting in Isolated Systolic Hypertension (ISH).
Question 3
When prescribing medications for an 85-year-old patient, the Nurse Practitioner must
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consider age-related changes in pharmacokinetics. Which of the following changes results
in a prolonged half-life of lipid-soluble drugs (e.g., Diazepam)?
A) Increased total body water.
B) Increased lean muscle mass.
C) Increased glomerular filtration rate.
D) Increased ratio of adipose tissue (body fat) to lean body mass.
E) Increased serum albumin levels.
Correct Answer: D) Increased ratio of adipose tissue (body fat) to lean body mass.
Rationale: With aging, lean body mass decreases (sarcopenia) and total body water
decreases, while the percentage of body fat increases. Lipophilic (fat-soluble) drugs have a
larger volume of distribution (
𝑉𝑑
) because they distribute into this increased fat tissue. This creates a reservoir effect,
leading to a prolonged half-life and potential toxicity if dosing is not adjusted.
Question 4
A 75-year-old patient reports difficulty hearing high-pitched tones, such as a microwave
beep or a grandchild’s voice. The NP suspects presbycusis. Which anatomical change is
primarily responsible for this sensorineural hearing loss?
A) Calcification of the ossicles in the middle ear.
B) Excessive accumulation of cerumen in the external canal.
C) Degeneration of hair cells in the Organ of Corti within the cochlea.
D) Perforation of the tympanic membrane.
E) Thickening of the eustachian tube.
Correct Answer: C) Degeneration of hair cells in the Organ of Corti within the cochlea.
Rationale: Presbycusis is the classic age-related, bilateral, high-frequency sensorineural
hearing loss. It is primarily caused by the loss of hair cells in the Organ of Corti (inner ear)
and degeneration of the cochlear nerve. Calcification of ossicles (Option A) causes
conductive loss, not sensorineural.
Question 5
The Nurse Practitioner is performing a respiratory assessment on an older adult. Which of
the following is considered a normal age-related change in the respiratory system?
A) Increased vital capacity.
B) Decreased residual volume.
C) Increased anterior-posterior (AP) chest diameter and decreased chest wall compliance.
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D) Enhanced cough reflex.
E) Increased number of alveoli.
Correct Answer: C) Increased anterior-posterior (AP) chest diameter and decreased chest
wall compliance.
Rationale: Normal aging involves stiffening of the chest wall (calcification of costal
cartilages) and kyphosis, which decreases compliance. The alveoli enlarge and lose
elasticity (senile emphysema), leading to air trapping. This results in an increased AP
diameter ("barrel chest" appearance similar to COPD but age-related) and Increased
Residual Volume, while Vital Capacity decreases.
Question 6
A geriatric patient presents with confusion and lethargy. The NP orders a Basic Metabolic
Panel (BMP). Why is Serum Creatinine often an unreliable indicator of renal function in
the elderly?
A) Elderly kidneys secrete excess creatinine.
B) Serum creatinine stays normal despite GFR decline due to decreased lean muscle mass.
C) Creatinine is metabolized faster by the aging liver.
D) Dehydration falsely lowers creatinine levels.
E) The lab tests are calibrated for younger adults only.
Correct Answer: B) Serum creatinine stays normal despite GFR decline due to decreased
lean muscle mass.
Rationale: Creatinine is a byproduct of muscle breakdown. Since older adults have reduced
muscle mass (sarcopenia), they produce less creatinine. Therefore, a "normal" serum
creatinine level (e.g., 0.9 mg/dL) may actually represent a significantly reduced Glomerular
Filtration Rate (GFR). Calculating Creatinine Clearance (CrCl) or eGFR is essential.
Question 7
In performing a Comprehensive Geriatric Assessment (CGA), the NP uses the Katz Index.
What does this tool specifically measure?
A) Instrumental Activities of Daily Living (IADLs) like balancing a checkbook.
B) Cognitive impairment and recall.
C) Basic Activities of Daily Living (ADLs) such as bathing, dressing, and toileting.
D) Risk for falls and gait stability.
E) Nutritional status and malnutrition risk.
Correct Answer: C) Basic Activities of Daily Living (ADLs) such as bathing, dressing, and
toileting.
Rationale: The Katz Index of Independence in Activities of Daily Living assesses the
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patient's ability to perform six basic functions: Bathing, Dressing, Toileting, Transferring,
Continence, and Feeding. It does not assess higher-level complex tasks (IADLs).
Question 8
Which assessment tool would be most appropriate to evaluate a patient’s ability to live
independently by assessing tasks such as shopping, managing finances, and using the
telephone?
A) The Katz Index.
B) The Lawton Scale.
C) The Mini-Mental State Exam (MMSE).
D) The Get-Up and Go Test.
E) The PHQ-9.
Correct Answer: B) The Lawton Scale.
Rationale: The Lawton Instrumental Activities of Daily Living (IADL) Scale measures
more complex skills required for independent living. These include using the phone,
shopping, food preparation, housekeeping, laundry, mode of transportation, responsibility
for own medications, and ability to handle finances.
Question 9
An 82-year-old female presents with a complaint of "dryness down there" and pain during
intercourse (dyspareunia). Which physiological change associated with menopause and
aging is the cause?
A) Hypertrophy of the vaginal mucosa.
B) Increased vaginal pH (more acidic).
C) Estrogen depletion causing atrophy and thinning of the vaginal epithelium.
D) Excessive production of cervical mucus.
E) Fungal overgrowth due to diabetes.
Correct Answer: C) Estrogen depletion causing atrophy and thinning of the vaginal
epithelium.
Rationale: Following menopause, the cessation of estrogen production leads to urogenital
atrophy. The vaginal epithelium becomes thin, pale, and dry, and the vaginal canal may
shorten and narrow. This leads to symptoms of dryness, itching, and dyspareunia (painful
sex).
Question 10
The NP is assessing an older adult's skin turgor to check for dehydration. What is the most
VERIFIED 2025 LATEST UPDATED ALREADY GRADED A+
Question 1
A 72-year-old male patient presents for an annual wellness exam. He complains that he
needs brighter light to read and has difficulty distinguishing between blue and green colors.
Based on normal age-related changes, what is the most likely physiological cause of these
symptoms?
A) Development of acute angle-closure glaucoma.
B) Yellowing and thickening of the lens (Nuclear Sclerosis).
C) Detachment of the retina.
D) Degeneration of the macula lutea.
E) Atrophy of the lacrimal ducts.
Correct Answer: B) Yellowing and thickening of the lens (Nuclear Sclerosis)
Rationale: As part of normal aging, the lens of the eye accumulates insoluble proteins,
causing it to thicken, harden, and turn yellow. This yellowing filters out shorter
wavelengths of light (blues and violets), altering color perception (specifically blue-green
discrimination). The thickening also requires more ambient light for light to penetrate to
the retina.
Question 2
During a cardiovascular assessment of an 80-year-old female, the Nurse Practitioner notes
a systolic blood pressure of 150 mmHg and a diastolic pressure of 80 mmHg (Isolated
Systolic Hypertension). Which age-related physiological change best explains this finding?
A) Increased elasticity of the aorta.
B) Increased sensitivity of the baroreceptors.
C) Stiffening of the large arteries (arteriosclerosis) and loss of elastic recoil.
D) Severe stenosis of the renal arteries.
E) Increased cardiac output at rest.
Correct Answer: C) Stiffening of the large arteries (arteriosclerosis) and loss of elastic
recoil.
Rationale: A hallmark of cardiovascular aging is the stiffening of the large elastic arteries
(aorta and major branches) due to collagen deposition and calcium accumulation. This loss
of elasticity (compliance) causes the systolic pressure to rise as the vessel cannot expand to
accommodate the stroke volume, resulting in Isolated Systolic Hypertension (ISH).
Question 3
When prescribing medications for an 85-year-old patient, the Nurse Practitioner must
,[Type here]
consider age-related changes in pharmacokinetics. Which of the following changes results
in a prolonged half-life of lipid-soluble drugs (e.g., Diazepam)?
A) Increased total body water.
B) Increased lean muscle mass.
C) Increased glomerular filtration rate.
D) Increased ratio of adipose tissue (body fat) to lean body mass.
E) Increased serum albumin levels.
Correct Answer: D) Increased ratio of adipose tissue (body fat) to lean body mass.
Rationale: With aging, lean body mass decreases (sarcopenia) and total body water
decreases, while the percentage of body fat increases. Lipophilic (fat-soluble) drugs have a
larger volume of distribution (
𝑉𝑑
) because they distribute into this increased fat tissue. This creates a reservoir effect,
leading to a prolonged half-life and potential toxicity if dosing is not adjusted.
Question 4
A 75-year-old patient reports difficulty hearing high-pitched tones, such as a microwave
beep or a grandchild’s voice. The NP suspects presbycusis. Which anatomical change is
primarily responsible for this sensorineural hearing loss?
A) Calcification of the ossicles in the middle ear.
B) Excessive accumulation of cerumen in the external canal.
C) Degeneration of hair cells in the Organ of Corti within the cochlea.
D) Perforation of the tympanic membrane.
E) Thickening of the eustachian tube.
Correct Answer: C) Degeneration of hair cells in the Organ of Corti within the cochlea.
Rationale: Presbycusis is the classic age-related, bilateral, high-frequency sensorineural
hearing loss. It is primarily caused by the loss of hair cells in the Organ of Corti (inner ear)
and degeneration of the cochlear nerve. Calcification of ossicles (Option A) causes
conductive loss, not sensorineural.
Question 5
The Nurse Practitioner is performing a respiratory assessment on an older adult. Which of
the following is considered a normal age-related change in the respiratory system?
A) Increased vital capacity.
B) Decreased residual volume.
C) Increased anterior-posterior (AP) chest diameter and decreased chest wall compliance.
,[Type here]
D) Enhanced cough reflex.
E) Increased number of alveoli.
Correct Answer: C) Increased anterior-posterior (AP) chest diameter and decreased chest
wall compliance.
Rationale: Normal aging involves stiffening of the chest wall (calcification of costal
cartilages) and kyphosis, which decreases compliance. The alveoli enlarge and lose
elasticity (senile emphysema), leading to air trapping. This results in an increased AP
diameter ("barrel chest" appearance similar to COPD but age-related) and Increased
Residual Volume, while Vital Capacity decreases.
Question 6
A geriatric patient presents with confusion and lethargy. The NP orders a Basic Metabolic
Panel (BMP). Why is Serum Creatinine often an unreliable indicator of renal function in
the elderly?
A) Elderly kidneys secrete excess creatinine.
B) Serum creatinine stays normal despite GFR decline due to decreased lean muscle mass.
C) Creatinine is metabolized faster by the aging liver.
D) Dehydration falsely lowers creatinine levels.
E) The lab tests are calibrated for younger adults only.
Correct Answer: B) Serum creatinine stays normal despite GFR decline due to decreased
lean muscle mass.
Rationale: Creatinine is a byproduct of muscle breakdown. Since older adults have reduced
muscle mass (sarcopenia), they produce less creatinine. Therefore, a "normal" serum
creatinine level (e.g., 0.9 mg/dL) may actually represent a significantly reduced Glomerular
Filtration Rate (GFR). Calculating Creatinine Clearance (CrCl) or eGFR is essential.
Question 7
In performing a Comprehensive Geriatric Assessment (CGA), the NP uses the Katz Index.
What does this tool specifically measure?
A) Instrumental Activities of Daily Living (IADLs) like balancing a checkbook.
B) Cognitive impairment and recall.
C) Basic Activities of Daily Living (ADLs) such as bathing, dressing, and toileting.
D) Risk for falls and gait stability.
E) Nutritional status and malnutrition risk.
Correct Answer: C) Basic Activities of Daily Living (ADLs) such as bathing, dressing, and
toileting.
Rationale: The Katz Index of Independence in Activities of Daily Living assesses the
, [Type here]
patient's ability to perform six basic functions: Bathing, Dressing, Toileting, Transferring,
Continence, and Feeding. It does not assess higher-level complex tasks (IADLs).
Question 8
Which assessment tool would be most appropriate to evaluate a patient’s ability to live
independently by assessing tasks such as shopping, managing finances, and using the
telephone?
A) The Katz Index.
B) The Lawton Scale.
C) The Mini-Mental State Exam (MMSE).
D) The Get-Up and Go Test.
E) The PHQ-9.
Correct Answer: B) The Lawton Scale.
Rationale: The Lawton Instrumental Activities of Daily Living (IADL) Scale measures
more complex skills required for independent living. These include using the phone,
shopping, food preparation, housekeeping, laundry, mode of transportation, responsibility
for own medications, and ability to handle finances.
Question 9
An 82-year-old female presents with a complaint of "dryness down there" and pain during
intercourse (dyspareunia). Which physiological change associated with menopause and
aging is the cause?
A) Hypertrophy of the vaginal mucosa.
B) Increased vaginal pH (more acidic).
C) Estrogen depletion causing atrophy and thinning of the vaginal epithelium.
D) Excessive production of cervical mucus.
E) Fungal overgrowth due to diabetes.
Correct Answer: C) Estrogen depletion causing atrophy and thinning of the vaginal
epithelium.
Rationale: Following menopause, the cessation of estrogen production leads to urogenital
atrophy. The vaginal epithelium becomes thin, pale, and dry, and the vaginal canal may
shorten and narrow. This leads to symptoms of dryness, itching, and dyspareunia (painful
sex).
Question 10
The NP is assessing an older adult's skin turgor to check for dehydration. What is the most
